401k Plan data: PCP, LLC HEALTH & WELFARE BENEFITS plan

PCP, LLC HEALTH & WELFARE BENEFITS 401k Plan overview

Plan Name	PCP, LLC HEALTH & WELFARE BENEFITS
Plan identification number	501

PCP, LLC HEALTH & WELFARE BENEFITS Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	SELECT distinct(Description) AS Description FROM 401k_benefit_codes LEFT JOIN 401k_benefit_code_description ON BenefitCode=Code COLLATE utf8_unicode_ci WHERE EIN='261616991' AND PlanID='501'

401k Sponsoring company profile

PCP, LLC has sponsored the creation of one or more 401k plans.

Company Name: PCP, LLC

Employer identification number (EIN): 261616991

NAIC Classification: 721199
NAIC Description: All Other Traveler Accommodation

Additional information about PCP, LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2007-12-17

Company Identification Number: 602788642

Legal Registered Office Address: 3006 NORTHUP WAY SUITE 100

BELLEVUE
United States of America (USA)
980041445

More information about PCP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PCP, LLC HEALTH & WELFARE BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-07-01 JULIE ROSS 2024-10-09
501 2022-07-01 JULIE ROSS 2023-10-30
501 2019-07-01
501 2018-07-01
501 2017-07-01 JULIE ROSS
501 2016-07-01 JULIE ROSS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-07-01	JULIE ROSS	2024-10-09
501	2022-07-01	JULIE ROSS	2023-10-30
501	2019-07-01
501	2018-07-01
501	2017-07-01	JULIE ROSS
501	2016-07-01	JULIE ROSS

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30004105

Policy instance

Insurance contract or identification number	30004105
Number of Individuals Covered	104
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $737
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

21667

Policy instance

Insurance contract or identification number	21667
Number of Individuals Covered	127
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $7,176
Total amount of fees paid to insurance company	USD $1,911
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $69,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6761100

Policy instance

Insurance contract or identification number	6761100
Number of Individuals Covered	63
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $21,402
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $503,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1640200

Policy instance

Insurance contract or identification number	1640200
Number of Individuals Covered	76
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $18,340
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $458,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30004105

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1640200

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6761100

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

21667

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30004105

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10217924

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

1D032581

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1640200

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30004105

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10217924

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

1D032581

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1640200

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6761100

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30004105

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10217924

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

1D032581

Policy instance

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6761100

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

1640200

Policy instance

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Company Name:	PCP, LLC
Employer identification number (EIN):	261616991
NAIC Classification:	721199
NAIC Description:	All Other Traveler Accommodation

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2007-12-17
Company Identification Number:	602788642
Legal Registered Office Address:	3006 NORTHUP WAY SUITE 100 BELLEVUE United States of America (USA) 980041445